The Feasibility and Safety of the Endoscopic Submucosal Dissection of Superficial Gastric Neoplastic Lesions in Patients with Compensated Liver Cirrhosis: A Retrospective Study.
- Author:
Jong Hak CHOI
1
;
Eun Ran KIM
;
Byung Hoon MIN
;
Dongil CHOI
;
Ki Joo KANG
;
Jun Haeng LEE
;
Poong Lyul RHEE
;
Jae J KIM
;
Jong Chul RHEE
Author Information
1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. bhmin@skku.edu
- Publication Type:Original Article
- Keywords:
Superficial gastric neoplastic lesion;
Endoscopic submucosal dissection;
Liver cirrhosis
- MeSH:
Bacteremia;
Fibrosis;
Follow-Up Studies;
Hemorrhage;
Humans;
Liver;
Liver Cirrhosis;
Recurrence;
Retrospective Studies
- From:Gut and Liver
2012;6(1):58-63
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: When undergoing endoscopic submucosal dissection (ESD), patients with liver cirrhosis (LC) may suffer from a high risk of bleeding, bacteremia and tissue vulnerability. There have been few reports evaluating the efficacy and safety of ESD in patients with LC. METHODS: From January 2004 to March 2010, 23 patients with LC (cirrhosis group) underwent ESD for superficial gastric neoplastic lesions. The number of patients with a liver function in the Child-Pugh classes A and B were 20 and 3, respectively. The clinical outcomes and complications were compared with 69 patients without LC (control group) that were matched for age and sex. RESULTS: The en bloc resection, R0 resection and en bloc plus R0 resection rates of the cirrhosis group were 82.6%, 91.3%, and 82.6%, respectively, and did not show significant differences from the rates of the control group. No local recurrence was found in either group during the follow-up period. The procedure length of time (41.0 vs 39.0 minutes), rate of bleeding (4.3% vs 7.2%) and rate of perforation (0.0% vs 1.4%) in the cirrhosis group were also comparable to the results from the control group. CONCLUSIONS: ESD was safely performed in patients with LC, and satisfactory outcomes were achieved with high en bloc and R0 resection rates for superficial gastric neoplastic lesions.